NPIMap

Individual provider Active NPI

Carrie Ann Wood, MD

  • Internal Medicine Physician
  • Shawnee, OK
National Provider Identifier
1871571901
Registry record updated Oct 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25980 Issued in OK
Practice address
2307 S Gordon Cooper Dr
Shawnee, OK 74801
Phone
(405) 273-5236
NPI assigned
Jan 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 23267 LA
Internal Medicine Physician 207R00000X 25980 OK Primary

Addresses

Primary practice location

2307 S Gordon Cooper Dr
Shawnee, OK 74801

Mailing address

2307 S Gordon Cooper Dr
Shawnee, OK 74801
Phone (405) 273-5236

Other identifiers 1

IdentifierTypeStateIssuer
G0715MedicaidNM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061129000394 TX Practitioner - Internal Medicine 3072511021 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Sanford School of Medicine of University of South Dakota, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Citizen Potawatomi NationGroup PAC ID 3375511488, 35 clinicians

Practice addresses (Care Compare)

2307 Gordon Cooper Dr
Shawnee, OK 74801-9007
Phone (405) 273-5236

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
23267LAMDInternal Medicine Physician
25980OKMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Citizen Potawatomi Nation CurrentSince Jun 2, 2015 Accepting new patients
Citizen Potawatomi Nation CurrentSince Jun 2, 2015 Accepting new patients
Citizen Potawatomi Nation Current Accepting new patients
Santa Clara Health Center PastSince Jan 19, 2012 Accepting new patients
Santo Domingo Health Clinic Past Accepting new patients
Summit Medical Center Past Accepting new patients
San Felipe Health Clinic Past Accepting new patients
Cochiti Health Clinic Past Accepting new patients

Locations

781 Grand Casino Blvd
Shawnee, OK 74804
Phone (405) 964-4025

2307 Gordon Cooper Dr
Shawnee, OK 74801
Phone (405) 273-5236

Interoperability endpoints

  • FHIR API: https://epicproxy.et1447.epichosted.com/APIProxyPRD/api/FHIR/R4

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1136764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318204800000",
    "number": "1871571901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2307 S GORDON COOPER DR",
            "city": "SHAWNEE",
            "state": "OK",
            "postal_code": "74801",
            "telephone_number": "405-273-5236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2307 S GORDON COOPER DR",
            "city": "SHAWNEE",
            "state": "OK",
            "postal_code": "74801",
            "telephone_number": "405-273-5236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOD",
        "first_name": "CARRIE",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-09",
        "last_updated": "2011-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "23267",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OK",
            "license": "25980",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "G0715",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shawnee, OK

Sources for this page

Verify at the official NPI Registry.